Table_3_Tattoos, piercings, and symptoms of ADHD in non-clinical adults: a cross-sectional study.pdf

IntroductionTattoos and piercings are associated with impulsive and risk-taking personality traits, which are also common along the ADHD continuum. However, studies on ADHD and body modification are lacking. Thus, this study aimed to assess the association between body modification and subclinical ADHD symptom severity and to investigate if body modification can serve as an indication for ADHD examination.
MethodsA total of 762 adults (529 women and 233 men) without a diagnosis of ADHD completed the adult ADHD Self-Report Scale (ASRS) and answered questions concerning body modification. Two different ASRS versions were utilized: the 18-item ASRS Symptom Checklist and the 6-item ASRS Screener. Three categorizations of body modifications were analyzed: (i) having at least one tattoo, (ii) having at least one piercing other than ear piercing, and (iii) the combination of simultaneously having at least one tattoo and one piercing. Mean 18-item ASRS total and subscale scores and the proportion of positive results on the 6-item ASRS Screener were compared between those with and those without body modifications while adjusting for covariates age and sex. Additional analyses were performed for ≥2 and ≥3 body modifications.
ResultsIn our cohort, 26% had a tattoo, 14% had a piercing other than ear piercing, and 8% had a combination of tattoo and piercing. Having any kind of body modification was associated with more pronounced symptoms of ADHD and with a cutoff score on the ASRS screener indicating ADHD. Whereas, the effect sizes were small for tattoos, medium to large effect sizes were seen for ≥2 piercings in the ASRS. Moreover, moderately strong associations emerged for ≥1 piercing and a positive ASRS screening result.
ConclusionOur results suggest that acquiring a body modification, especially a tattoo, is entering the mainstream in Sweden. Correspondingly, differences in subclinical ADHD symptomatology between non-clinical adults with and without body modifications are subtle. Having ≥2 piercings other than ear piercings, on the other hand, is associated with clinically relevant differences in ADHD symptoms. Moreover, piercing status may serve as an indicator, among others, for further ADHD assessments. However, more research is needed to ascertain the possible signaling functions of body modifications in clinical settings.

研究背景：纹身与身体穿孔常与冲动性、冒险性人格特质相关，而这类特质同样常见于注意缺陷多动障碍（Attention Deficit Hyperactivity Disorder, ADHD）的谱系表现中。然而，目前针对ADHD与身体改造的相关研究仍较为匮乏。因此，本研究旨在评估身体改造与亚临床ADHD症状严重程度之间的关联，并探究身体改造是否可作为ADHD筛查的提示指征。

研究方法：本研究共纳入762名未被诊断为ADHD的成年人（其中女性529名，男性233名），所有受试者均完成了成人ADHD自评量表（Adult ADHD Self-Report Scale, ASRS），并填写了关于身体改造的相关问卷。本研究使用了两种版本的ASRS量表：18项ASRS症状清单与6项ASRS筛查量表。本研究对三类身体改造情况进行了分析：(i) 至少拥有1处纹身；(ii) 至少拥有1处非耳部穿孔；(iii) 同时拥有至少1处纹身与1处穿孔。本研究在控制年龄、性别作为协变量的前提下，对比了存在与不存在身体改造的受试者的18项ASRS总分及分量表均分，以及6项ASRS筛查量表的阳性结果占比。此外，本研究还针对≥2处、≥3处身体改造的情况开展了额外分析。

研究结果：在本研究队列中，26%的受试者拥有纹身，14%的受试者拥有非耳部穿孔，8%的受试者同时拥有纹身与穿孔。存在任意类型身体改造的受试者，其ADHD症状更为显著，且ASRS筛查量表得分达到ADHD判定临界值。其中，纹身相关的效应量较小，而≥2处穿孔的效应量则达到中等至较大水平。此外，≥1处穿孔与ASRS筛查阳性结果之间存在中等强度的关联。

研究结论：本研究结果显示，在瑞典，进行身体改造（尤其是纹身）正逐渐成为主流行为。相应地，有无身体改造的非临床成年人之间，其亚临床ADHD症状的差异较为细微。然而，≥2处非耳部穿孔与ADHD症状存在具有临床意义的差异。此外，穿孔情况可作为进一步开展ADHD评估的提示指征之一。不过，仍需开展更多研究以明确身体改造在临床场景中的潜在信号提示作用。